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1417485012
MYCHEAL L MIMES
SHREVEPORT, LA
NPI
1417485012
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
104100000X Social Worker
Enumeration Date
2017-05-25
Last Update Date
2018-05-23
Business Address
MYCHEAL L MIMES
1500 N MARKET ST UNIT C
SHREVEPORT, LA 71107
Phone number: 318-626-5597
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Mailing Address
MYCHEAL L MIMES
1500 N MARKET ST UNIT C
SHREVEPORT, LA 71107-6537
Phone number:
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